Nursing Assessment - Pharmacology

Patients who abuse drugs require a careful and complete assessment which includes vital signs (temperature, blood pressure, heart rate, and respiratory rate). Pupil size is inspected and the skin is examined for needle marks and abscesses. The patient’s nutrition, elimination, and sleep patterns are noted, too. Determine if the patient has a past medical history of drug use, drug abuse, and related drug illnesses such as HIV, cellulitis, endocarditis, and pneumonia or other respiratory problems.

The following are commonly used nursing diagnoses for drug abuse patients:

  • Knowledge deficit related to denial of problem
  • Ineffective individual coping related to lack of support system
  • Risk for violence to oneself or others related to drug use
  • Altered health maintenance related to drug dependency
  • Ineffective management of therapeutic regimen

The plan of care for a patient who is a drug abuser will depend on the reason for hospitalization. The physical response to drug use should be monitored and any infections or disease states must be treated. The plan should also include treatment for the abuse in a supportive and rehabilitative setting. This may include counseling, psychotherapy sessions, and medications to overcome the withdrawal symptoms.

Nursing implementation may focus on managing the patient’s acute intoxication and withdrawal and then monitoring the effectiveness of therapy to treat the patient’s substance abuse problem.

The evaluation of the effectiveness of the treatment centers on how well the patient is successfully detoxified and withdrawn from the drug and how well the patient refrains from re-abusing the substance. It is important for nurses to realize that overcoming a drug addiction is a long and sometimes lifetime task. Patients may have many relapses along the way and the process can seem frustrating and hopeless. However, the nurse should remain non-judgmental and objective when caring for substance abuse patients.


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